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Latent growth trajectories of county-level diabetes prevalence in the United States, 2004-2017, and associations with overall environmental quality
Journal article   Open access   Peer reviewed

Latent growth trajectories of county-level diabetes prevalence in the United States, 2004-2017, and associations with overall environmental quality

Tara P McAlexander, Jyotsna S Jagai and Leslie A McClure
Environmental epidemiology, v 6(4), pp e218-e218
01 Aug 2022
url
https://doi.org/10.1097/ee9.0000000000000218View
Published, Version of Record (VoR)CC BY-NC-ND V4.0 Open
url
https://doi.org/10.1097/EE9.0000000000000218View
Published, Version of Record (VoR) Open

Abstract

The prevalence of type 2 diabetes (T2D) has increased in the United States, and recent studies suggest that environmental factors contribute to T2D risk. We sought to understand if environmental factors were associated with the rate and magnitude of increase in diabetes prevalence at the county level. MethodsWe obtained age-adjusted diabetes prevalence estimates from the CDC for 3,137 US counties from 2004 to 2017. We applied latent growth mixture models to these data to identify classes of counties with similar trends in diabetes prevalence over time, stratified by Rural Urban Continuum Codes (RUCC). We then compared mean values of the US EPA Environmental Quality Index (EQI) 2006-2010, overall and for each of the five domain indices (air, water, land, sociodemographic, and built), with RUCC-specific latent class to examine associations of environmental factors and class of diabetes prevalence trajectory. ResultsOverall diabetes prevalence trends between 2004 and 2017 were similar across all RUCC strata. We identified two classes among metropolitan urbanized (RUCC 1) counties; four classes among non-metro urbanized (RUCC 2) counties; and three classes among less urbanized (RUCC 3) and thinly populated (RUCC 4) counties. Associations with overall EQI values and class of diabetes prevalence trends differed by RUCC strata, with the clearest association between poor air EQI and steeper increases in diabetes prevalence among rural counties (RUCC 3 and 4). ConclusionsSimilarities in county-level diabetes prevalence trends between 2004 and 2017 were identified for each RUCC strata, although associations with environmental factors varied by rurality.

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2 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#11 Sustainable Cities and Communities
#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Environmental Sciences
Public, Environmental & Occupational Health
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